MEDICARE: MO MEDICAL CONSULTING

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	M2806	TX
2	207RC0001X	Clinical Cardiac Electrophysiology Physician	M2806	TX
3	207RC0000X	Cardiovascular Disease Physician	M2806	TX

General Provider Information

NPI Number	:	1033571880
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MO MEDICAL CONSULTING

Provider Business Mailing Address
First Line	:	3505 SAGE RD
Second Line	:	UNIT 414
City	:	HOUSTON
State	:	TX
Zip	:	77056-7016
Country	:	US
Telephone Number	:	281-660-4884
Fax Number	:

Provider Business Practice Location Address
First Line	:	3505 SAGE RD
Second Line	:	UNIT 414
City	:	HOUSTON
State	:	TX
Zip	:	77056-7016
Country	:	US
Telephone Number	:	281-660-4884
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR
Name	:	DR. MOSSAAB SHURAIH
Credential	:	MD
Telephone Number	:	281-660-4884

Provider Enumeration Date	:	03/22/2016
Last Update Date	:	03/22/2016

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Directions to “MO MEDICAL CONSULTING ” Practice Location

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